Ka Wai Ola - Office of Hawaiian Affairs, Volume 23, Number 5, 1 May 2007 — Motherhood and the circle of life [ARTICLE+ILLUSTRATION]

Motherhood and the circle of life

Native Hawaiian women have more "adverse pregnancy outcomes" than Caucasian, Japanese, Filipino and Chinese women in Hawai'i. Eaeh year, about six percent of Hawaiian babies are born with physical defects and challenges, accounting for 26 percent of all new birth defect cases. Sadly, such birth defects result in lifelong challenges. What causes these poor reproductive outcomes? Researchers studied prenatal medical histories and found substance abuse in more than half (54.2 percent) of the Hawaiian women, compared to 25 percent of women of other ethnicities. In descending order

of frequency, the illieiī substances found were methamphetamine, marijuana and eoeaine. In many cases, aleohol was also consumed during pregnancy. On average, four percent of Hawaiian infants are diagnosed with Fetal Aleohol Syndrome Disorder (FASD), whieh causes lifelong mental and physical challenges. Clearly, drug and aleohol use during pregnancy are significant causes of the adverse reproductive outcomes in such a high percentage of Hawaiian newborns. Abstinence from illegal substances and aleohol during pregnancy ean definitely reduce birth defects among Hawaiian infants. Years ago, researchers found that cigarette smoking during pregnancy resulted in newborns that were helow nonnal size, and these infants continued to be smaller than average for several

years. Smoking cigarettes causes internal blood vessels, like those that supply the fetus, to heeome smaller. As a result, less nutri-ent-rich blood flows to the fetus. Also, many smokers eat less, further limiting the food supply to their unborn child. Smoking negatively effects the overall development of the unborn child, creating many lifelong challenges after birth. Clearly, abstaining from cigarette smoking during pregnancy ean give newborns a better start in life. Careless behavior during pregnancy is not Hawaiian. Traditional family dynamics protected against it, since Hawaiians knew that strong and healthy women are crucial to assuring the healthy continuation of the 'ohana. Careful supervision of a girl's development began at birth. Actually, all children got healthy diets, massage and lots of

physical activity. In the prenatal period, women worked together preparing clothing, bedding and necessities for the infant and mother. According to Mary Kawena Pūku'i, the diet of the expectant mother was carefully supervised by family elders. Greens assured ealeium and other nutrients needed to build and strengthen the baby's body. Fish, taro, sweet potatoes, vegetables, fruit and water rounded out the diet, while strongly flavored foods were avoided. During the last three months, the expectant mother was encouraged to eat sparingly of everything except greens and poi, to avoid complications at birth caused by overweight of the infant and mother. Keeping our keiki healthy is difficult. Heakh experts agree that, today, many youngsters get too little physical activity and eat too mueh food of poor nutritional value. Our kids have more opportunity to experiment with

harmful practices, such as aleohol consumption, smoking and taking illieiī drugs. They don't realize the great consequences of such mistakes, nor that some are life-threatening. Traditional ehildrearing practices ean offer clues on how to keep the 'ohana close and the family roles defined and clear. Kawena Pūku'i reminds us that newborns are new links in the family's ehain of heredity. Inherited mana from our ancestors passes through us to our children and from them to their children. In turn, after death, we become the ancestors and, if wise enough, perhaps an 'aumakua who will guide and protect the generations to eome. Thus, as mākua and kūpuna, it is our kuleana to persevere at protecting the heahh and wellbeing of the women and keiki of our 'ohana, so that eaeh may achieve their full potential and fulfill their own kuleana. That's the Hawaiian circle of life. S

OLAKINO • Y0UR HEALĪH

By Claire Ku'uleilani Hughes, Dr. PH„ R.D.